Individual
DR. JONATHAN MARIUS RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
3824 RINGGOLD RD, EAST RIDGE, TN 37412-1640
(423) 629-6015
Mailing address
115 S PALISADES DR, SIGNAL MOUNTAIN, TN 37377-2920
(209) 923-3709
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12084
TN
122300000X
Dentist
64680
CA
Other
Enumeration date
07/13/2015
Last updated
03/10/2023
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